What to Know About Starting Birth Control After Pregnancy

After having a baby, it’s possible to get pregnant even before your period starts again. Using birth control will help lower your risk of pregnancy.

Almost all birth control methods can be started right after giving birth.

There are just a few exceptions:

• Hormonal birth control pill, ring, and patch. These methods all contain estrogen, except for the “mini pill.” Estrogen may affect your breast milk supply in the first weeks after birth. If you plan to breastfeed, it’s best to delay the use of these birth control methods until around 4 to 6 weeks after delivering your baby.
• Cervical cap, diaphragm, and birth control sponge. It’s a good idea to delay using these methods until 6 weeks postpartum to give your cervix some time to return to its normal size. If you used one of these methods before pregnancy, you’ll need to be refitted.

There’s no one-size-fits-all approach to birth control after pregnancy. Instead, there are many different factors that determine the best fit for you.

You may want to consider the following:

• If you decide to use the pill, patch, or ring, will you find it difficult to remember to take or change it on a regular basis? You’ll have your hands and schedule full with a tiny new human!
• How long do you think it will be until you try to get pregnant again? If you don’t plan to get pregnant again for many years, you might prefer to use a long-acting method of birth control such as an implant or IUD. If you plan to get pregnant again sooner, you might prefer a method that you can use on a month-to-month or as needed basis.
• If you get an IUD or implant, it will need to be removed by a doctor if you decide you want to try for pregnancy again. You can stop other methods on your own.
• If you get the birth control shot, it can take several months after the last shot for your normal fertility to return. With all other birth control methods, it’s often possible to get pregnant right after you stop using it.

Another important point to consider: How effective do you want your birth control method to be? The effectiveness of different birth control methods can vary from 71 percent to 99 percent.

That’s quite a range! If you really don’t want to get pregnant, choosing something closer to 100 percent will definitely matter.

All birth control methods are safe after pregnancy. There are many options to choose from. They’re often grouped into three categories: hormonal, barrier, and lifestyle.

There are also permanent options if you decide you never want to be pregnant again.

Hormonal birth control

Hormonal birth control releases estrogen, progestin (the synthetic form of progesterone), or both into your body. These hormones prevent ovulation.

Ovulation happens when your body releases an egg. If this egg is fertilized by sperm, it can lead to pregnancy. If ovulation doesn’t happen, no egg is released and pregnancy can be avoided.

Birth control implant

A birth control implant is a matchstick-sized plastic rod that a doctor can insert into your upper arm. That’s it! After it’s been inserted, it’s 99 percent effective at preventing pregnancy for up to 5 years — with no maintenance required until the time comes to remove it.

You can have it removed early if you want to get pregnant before the 5-year mark.

Hormonal intrauterine device

A hormonal intrauterine device (IUD) is a small, T-shaped piece of plastic that releases the hormone progestin. If you choose this method of birth control, a medical professional will insert the device through your vagina and into your uterus.

An IUD is 99 percent effective at preventing pregnancy for 3 to 7 years. The length of time that an IUD works depends on the specific type that you get.

If you want to get pregnant before 3 to 7 years have passed, you can have an IUD removed at any time.

Birth control shot

If you decide to use the birth control shot, a healthcare provider will give you the injection once every 3 months. It’s 94 percent effective.

After your last shot, there may be a delay before your normal fertility returns.

Vaginal ring

This is a small flexible ring that you can insert into your vagina. It releases hormones that lower the risk of pregnancy. You keep the ring in for 3 to 5 weeks, before removing it and inserting a new ring for the next cycle.

It’s 91 percent effective.

Birth control patch

The patch is a small sticky patch that you can attach to your back, buttocks, stomach, or outer upper arm. You should replace it weekly.

It’s 91 percent effective.

Birth control pill

There are two main types of birth control pill available. One is the combination pill, which contains both estrogen and progestin. The other is the progestin-only pill (sometimes called the “mini pill”).

For both types, you swallow one pill per day.

Birth control pills are 91 percent effective — but keep in mind that as long as you take it every day, the combination pill is a little more flexible in terms of timing. The mini pill needs to be taken at the same time every day.

Barrier methods

The second category of birth control is barrier methods. They block sperm from reaching and fertilizing an egg. If sperm can’t reach an egg, no pregnancy can occur.

Copper IUD

This type of IUD is like a hormonal IUD, but it contains no hormones. Instead, it’s wrapped in copper. Copper prevents sperm from traveling normally, so it won’t be able to reach the egg.

Copper IUDs are 99 percent effective and can last up to 12 years. An IUD can be removed earlier if you want to become pregnant.

Internal condom (previously known as female condom)

This is a soft plastic pouch that you can insert into your vagina before having sex. This creates a physical barrier that prevents sperm from entering.

If you use an internal condom every time you have sex, it’s 79 percent effective.

Condom

This is a thin sheath-shaped device made from plastic, lambskin, or latex. You or your partner can slide it over your partner’s penis before you have sex. It will catch their sperm and help stop it from accessing the egg.

If you use a condom every time you have sex, it’s 85 percent effective.

Diaphragm

This device is made of silicone and shaped like a small shallow bowl. To use it, you insert it into your vagina to cover your cervix before having sex. You can leave it in place for up to 6 hours after sex.

You’ll need to use spermicide with the diaphragm to ensure up to 88 percent effectiveness.

Your healthcare provider will fit you and prescribe the right size of diaphragm. If you used a diaphragm before having a baby, you may need to be refitted after pregnancy.

Cervical cap

A cervical cap is similar to a diaphragm but smaller and more cup-shaped. To use it, you insert it into your vagina before having sex. It can stay there for up to 2 days.

A cervical cap needs to be used with spermicide. Your healthcare provider will give you a prescription for the right fit.

It’s 71 percent effective in people who’ve previously given birth.

Birth control sponge

The sponge is a soft, spongy device designed for one-time use. You may insert it into your vagina up to 24 hours before sex.

It will help cover your cervix to block sperm from accessing the egg. It also contains spermicide that changes the way that sperm moves.

This method of birth control prevents pregnancy 76 percent of the time in people who’ve previously given birth.

Spermicide

Spermicide is a chemical that changes the action of sperm, preventing it from swimming normally to fertilize an egg.

This type of birth control is often used with a cervical cap or diaphragm, but it can also be used on its own. It’s 71 percent effective when used alone.

There are different types of spermicide available, so check the package to ensure you’re using it correctly. Typically it’s a cream, gel, or suppository that may be inserted into your vagina to cover your cervix.

Lifestyle birth control

The third category of birth control doesn’t rely on any sort of hormonal or barrier device. Instead, it involves methods based on self-awareness and control. You know yourself best and will know whether these are good options to consider.

Fertility awareness

In this method of birth control, you avoid sex or use a barrier method on your most fertile days. This reduces your chance of getting pregnant.

You’re most fertile on the days near ovulation. So this method relies on knowing when ovulation occurs. Checking your cervical mucus and body temperature, as well as tracking your menstrual cycle length, will give you clues about when you’re likely to ovulate.

Depending how regular your cycle is and how closely you’re monitoring it, this method is considered to be 75 percent to 88 percent effective.

Pull-out method

Just as it sounds, this methods requires your partner to pull their penis out of your vagina before they ejaculate (when sperm is released). This will lower the chances of sperm entering your vagina. But keep in mind that small amounts of sperm can be released before ejaculation.

The effectiveness of this method is around 78 percent.

Abstinence

Generally, abstinence involves avoiding sexual intercourse or choosing to be intimate in other ways that can’t result in pregnancy.

Total avoidance of intercourse is 100 percent effective at preventing pregnancy.

Permanent birth control

The last group of birth control methods includes permanent methods.

If you’ve decided that you’re done having kids, these methods might be something to consider.

Tubal ligation

This is a type of surgery that cuts or blocks off your fallopian tubes. Your fallopian tubes are the pathway that an egg takes from your ovaries to your uterus.

This surgery is often done laparoscopically. A surgeon will make a few small incisions and then band or cut both fallopian tubes. Afterwards, an egg won’t be able to access the part of your fallopian tubes where it could meet sperm.

This procedure is more than 99 percent effective at preventing pregnancy.

Vasectomy

A vasectomy is a minor procedure that cuts or blocks the tube that sperm travels through during orgasm. This prevents sperm from leaving the testicles. While semen will still be released during orgasm, it won’t contain sperm to fertilize an egg.

It may take a few months for semen to become fully sperm-free after a vasectomy. After 3 months have passed, a vasectomy is nearly 100 percent effective at preventing pregnancy.

The potential side effects of birth control vary depending on the type of birth control you use.

Birth control pill, ring, or patch

Common side effects of these hormonal methods of birth control include:

• headache
• changes in the amount of bleeding or length of your period
• bleeding in between periods
• sore breasts
• mood changes

These side effects often improve or go away after the first 3 months.

In people over the age of 35 who smoke, there’s a small chance that using these methods of birth control may lead to the development of blood clots, heart attack, or stroke. This risk can be minimized by using a progestin-only pill (“mini pill”).

Birth control shot

The birth control shot can cause similar side effects as other hormonal birth control methods, which are described above.

The shot also sometimes causes some bone loss. Bone loss seems to be reversed after stopping the shot.

IUDs

After having an IUD implanted, you may experience some cramping or discomfort in the first weeks or months. There may also be changes in your period.

Barrier methods

These types of birth control may cause some discomfort or irritation for either partner. There is also potential for an allergic reaction to latex or spermicide.

Most birth control methods are just as effective after having a baby. There are just a few exceptions:

• If you previously used a diaphragm or cervical cap, you’ll need to be refitted by your healthcare provider now that you’ve had a baby.
• Sponges are less effective in people who’ve previously given birth. The effectiveness of the sponge drops from 88 percent to 76 percent after birth.
• The cervical cap is also less effective in those who’ve given birth. Its effectiveness declines from 86 percent before pregnancy to 71 percent after giving birth.

Yes. The good news is that all methods of birth control are safe to use while breastfeeding.

You may want to delay using a birth control pill, patch, or ring that contains estrogen for a few weeks because estrogen may decrease your milk supply.

If you’ve been breastfeeding for 4 to 6 weeks and your breast milk supply is well-established, then any birth control method is fine.

Exclusive breastfeeding can prevent your body from ovulating — or releasing an egg. If you don’t ovulate, you won’t be able to get pregnant.

If done correctly, exclusive breastfeeding can be 98 percent effective for preventing pregnancy.

There are a few things to consider with this method:

• It works best if your baby is exclusively breastfeeding. If your baby is drinking some formula or you’re pumping some milk, it won’t be as reliable.
• To be most effective, your baby needs to be breastfeeding at least once every 4 hours during the day and at least every 6 hours overnight.

Typically, exclusive breastfeeding only works as a birth control method for the first 6 months of your baby’s life. If your period returns before 6 months have passed, this method of birth control will no longer be effective.

It also becomes less effective when your baby:

• starts sleeping longer overnight (but hurray for sleep!)
• goes longer between day feedings
• starts eating solids

At that point, you may want to consider a birth control method that offers more protection.

If you’re serious about avoiding pregnancy, exclusive breastfeeding may not be the best choice of birth control. In some cases, ovulation can occur even with exclusive breastfeeding.

There are many things to consider when deciding what type of birth control to use after pregnancy. Effectiveness, ease of use, side effects, and your long-term family planning goals are all important to consider when making this choice.

Once you determine your priorities, you can narrow your birth control choices down to a few options. When you’re ready, book an appointment with your healthcare provider (if needed) to put your birth control plan into action.

Now you can get back to snuggling that new baby! Or if your baby happens to be sleeping, it’s time for another choice: sleep or have a shower? Now that’s a tough decision.